HomeMy WebLinkAboutDrain Layers Permit 181 Tumblebrook Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut /� ,S
List.No.: _1�J� hs
DRAIN LAYEVS PERMIT ND 1569
�'�►S 10 pig
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below'at 1. �'f 3 TI'1'r1 BED 1i G 1
1
;� �L►_y� 1�r Jcon the
side, between
at premises owned by
whose address is
and to __)!L_Lay'House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY S9,WAGE INDUSTRIAL WASTES .( ),,.OR
Connection will be made with ( 0
Petmi4 to be issued to .12 Ili=S'7 . Cey '� G
the holder of Drain Layers License No: : Permit will expire on 19
The undersigned.Drain Lgyer hereby:agrees to:all the terms and conditions set forth on the,permit and'the reverse side
thereof. Applicant has.received Town Permit No. and/or'C H D Permit No:
for street excavation..
SPECIAL CONDITIONS
Q/ Signed
Connection Charge Paid', Licensed Ofiia Layer .
Issued by
Tax Collector.
Permit Fee:. Paid $
INSPECTION: Check Number: 4019
INITIAL (Sig)
FINAL (Sig)
APPROVED —/Z ' 79 (Date)
INS O �� (Sig)
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